In a drug use survey of 457 final-year medical students a self-administered questionnaire included the controversial question whether such questionnaire should be onymous or anonymous. Definite answers either in favour of or against anonymity were given by 216 respondents. Of these, 72.2 per cent were in favour of anonymity, only 27.8 per cent favoured onymity. Among those who provided ambiguous answers, or who did not respond on the issue of anonymity vs. onymity, there were significantly more drug users. Where there was no family history of drug use, or where parents definitely disapproved of drug use, a high proportion of respondents were in favour of anonymity.

The question of onymity and anonymity in responding to a self-administered questionnaire on drug use has remained controversial. It has been thought that this issue might affect the reliability and validity of results. Although there are a few studies on this subject [1, 2], they do not provide conclusive evidence for or against anonymity. For this reason the respondents in this study were approached directly to obtain their opinions on whether the drug survey questionnaire should be onymous or anonymous.

The questionnaire on drug use was structured and distributed in a classroom situation to all the 457 final-year medical students of five colleges from the State of Uttar Pradesh who were posted to the Mental Hospital, Agra, during 1979 for their compulsory training in psychological medicine. The question of onymity or anonymity was included in the questionnaire which was explained to the students at length. The students were instructed not to disclose their identity but were asked to record whether they thought the questionnaire should be onymous or anonymous.

Nearly half of the students, 47.3 per cent, gave a definite opinion in favour of or against anonymity, while 52.7 per cent replied ambiguously or did not respond at all. Among those who expressed an explicit opinion, 72.2 per cent were in favour of anonymity while 27.8 per cent favoured onymity. Table 1 shows that in all sub-groups of the sample, those in favour of anonymity outnumbered their counterparts.

Table 1

Frequency of drug use and onymity versus anonymity

Onymous

Anonymous

Ambiguous or no opinion

Total

Drugs use

M

F

T

M

F

T

M

F

T

M

F

T

Regular

5

0

5

14

1

15

41

7

48

60

8

68

Casual

17

0

17

38

17

55

63

8

71

118

25

143

Occasional

7

1

8

15

4

19

33

4

37

55

9

64

Ever use

13

0

13

27

4

31

37

7

44

77

11

88

No use

10

7

17

18

18

36

16

25

41

44

50

94

Total

52

8

60

112

44

156

190

51

241

354

103

457

Note:M = male, F = female, T = total.

The percentage of female students who favoured anonymity was significantly higher than that of male students (p < 0.05). This difference was even more pronounced in the group of drug users. There was also a significant difference with regard to drug use between those who expressed an explicit opinion on the question of anonymity and those who refrained from doing so, the latter group having a higher frequency of drug use (p < 0.01). This pattern was repeated with respect to the use of specific substances, with the exception of tranquillizers and analgesics (see table 2).

The group of subjects where there was no history of family drug use had a significantly higher proportion of respondents in favour of anonymity than those with a history of family drug use.

Table 2

Drugs users with regard to onymity versus anonymity

Number of drugs users

Substance(s) used

Onymous

Anonymous

Ambiguous or no opinion

Total

Alcohol

5

10

18

33

Hypnotics and sedatives

1

1

2

4

Tranquillizers

2

5

4

11

Analgesics

6

27

23

56

Cannabis

7

1

54

62

Cannabis with other drugs

15

55

73

143

Other drugs (excluding cannabis)

7

21

26

54

Total

43

120

200

363

With respect to parental attitude towards drug use, a higher percentage (56 per cent) expressed a definite opinion on onymity versus anonymity in the group where parents disapproved of drug use. A significantly higher percentage of this group favoured anonymity (41 per cent) compared with the group where parental attitudes were tolerant or indifferent towards drug use (26 per cent).

Table 3

Attitudes of parents toward drug use in relation to the opinion of students on onymity versus anonymity

The findings of the study seem to refute the opinion held in some circles that the use of onymous or anonymous questionnaires should make no significant difference in the data obtained from drug surveys.

A significantly larger number of those who gave a definite opinion on the issue of onymity versus anonymity were in favour of keeping the questionnaire anonymous. If the respondents are asked to disclose their identity, it is more likely that they will give false negative responses. Only among cannabis users did the number of students who favoured onymity exceed those who were in favour of anonymity. It has been reported that cannabis users have a lower need for social approval and are dissatisfied with the established order of society [3 - 5]. They may also believe in the implicit religious and social sanction of using cannabis-type drugs
[
6] and that the use of these drugs will facilitate their religious fervour
[
7] . They would, therefore, see no harm in disclosing their identity.

Students with a family history of drug use were less frequently in favour of anonymity than students with no such history. In the former case it is supposed that the student may not consider drug use as stigmatic. Likewise, students whose parents diasapproved of drug use were significantly more in favour of anonymity than where parental attitudes were tolerant or indifferent towards drug use. This observation confirms the role of the family milieu and socio-cultural setting in determining student's attitudes towards onymity versus anonymity.

The purpose of the investigation, and the socio-cultural and family background of the population studied, should be considered when deciding on the issue of onymity or anonymity of a questionnaire. If the purpose of tile investigation is to ascertain the prevalence and pattern of drug abuse, then the use of an anonymous questionnaire may be more appropriate. 11, however, the purpose of the investigation is to carry out an in-depth study of the users and non-users of dependence-producing drugs, then onymous methods may be preferred.